Frailty is defined by the World Health Organization as a state of increased vulnerability in older adults, characterized by a decline in physiological functions across multiple systems and heightened sensitivity to external stressors. The global prevalence of frailty is expected to rise due to population ageing, highlighting the need for effective preventive strategies. However, while diet can play a crucial role in this context, their relationship is complex and potentially bidirectional: unhealthy dietary patterns may contribute to the onset of frailty, whereas early stages of frailty may influence food choices through limitations in meal preparation, and appetite. Hence, identifying biomarkers associated with frailty phenotypes may help clarify these mechanisms and improve prevention strategies. This systematic review aims to summarize current evidence on metabolomics-derived biomarkers potentially involved in the relationship between dietary patterns and frailty. A comprehensive literature search was conducted across three electronic databases (PubMed, Web of Science, Scopus) in accordance with the PRISMA guidelines, yielding 1661 studies, of which five met the inclusion criteria. Three dietary exposures were identified and analyzed: fruit and vegetable, plant/animal protein intake, and adherence to the Mediterranean diet. The findings suggest that specific metabolites, such as hippuric acid, different amino acids, and lipid derived compounds may represent potential candidates for establishing a metabolic signature of frailty. Nevertheless, current evidence remains limited and unclear about the direction of associations. Further research is needed, particularly in healthy populations, to validate the effectiveness of these biomarkers, and tailor guidelines specific for older adults.

To examine the association between relative sit-to-stand (STS) power and age, establish sex-specific cut-off points, and evaluate their associations with adverse outcomes in Colombian older adults. Cross-sectional, population-based study. Health, Well-being, and Aging Study (SABE-Colombia, 2014-2015). 3051 community-dwelling adults aged ≥60 years (56.6 % women; mean age 68.6 ± 6.4 years). Relative STS power (W·kg⁻¹) was estimated using a validated equation. Quantile regression examined age-related changes across percentiles (Q10-Q90). Receiver operating characteristic (ROC) curves with the Youden index determined cut-off points. Age-adjusted logistic regression tested associations with frailty, functionality as gait speed and handgrip strength (HGS), and depression. Optimal cut-offs for low relative STS power were 2.11 W·kg⁻¹ for men and 1.63 W·kg⁻¹ for women. Prevalence of low STS power was 34.3 % in men and 34.8 % in women, increasing with age in both sexes. Quantile regression revealed steeper age-related declines at higher percentiles, particularly among men. Low relative STS power was significantly associated with frailty and low functionality. Relative STS power is a simple, clinically feasible biomarker to identify functional impairment in older adults. The sex-specific thresholds reported for Colombian populations reflect demographic differences in muscle physiology and decline. Their integration into geriatric practice may enhance early detection, guide preventive interventions, and ultimately improve health outcomes in aging populations.

Frailty, a geriatric syndrome commonly used to identify vulnerable older adults, is a public health priority. However, the lack of cross-national comparisons of frailty trajectories and their distribution constrains current understanding of normative changes in frailty for residents across different countries. To derive longitudinal percentiles of frailty using a consistent cross-country approach. Observational study using longitudinal data from the Survey of Health, Ageing and Retirement in Europe (SHARE) between 2004 and 2020. We fit the distribution of the FI by Generalized Additive Models for Location, Scale, and Shape (GAMLSS), assessed the role of sex (male/female), education (in years), and migration status (migrant/non-migrant), and estimated the longitudinal percentiles of frailty using a consistent cross-country approach for 16 countries. Individuals aged ≥65 years (N = 42,951) at study entry. Frailty index (FI) based on the accumulation of deficits in 40 items. The results show that education is protective against frailty in all countries (a decrease of 1.1 pp. in Switzerland to 5.7 pp. in Slovenia, all p < 0.001). In most countries, women are frailer than men and migrant individuals have higher levels of frailty than non-migrants. FI trajectories showed heterogeneity across countries. The quantiles for women and migrants suggest frailer trajectories than men and non-migrants respectively. Findings from this cross-national comparison provide a framework within which the longitudinal norms of frailty trajectories from different countries can be interpreted.

Frailty is a major public health concern in aging populations. Socioeconomic disadvantage increases the risk of frailty, yet the mechanisms underlying this association remain unclear. To examine the mediating role of chronic diseases in the longitudinal association between socioeconomic disadvantage and frailty. Population-based cohort study. Lausanne, Switzerland. 4731 community-dwelling adults aged 65-70 years at recruitment (2004, 2010, and 2014), followed for up to 16 years, as part of the Lausanne Cohort 65+. None. Socioeconomic disadvantage was assessed using indicators of education, occupation, income, health insurance subsidy, and financial strain. Frailty was measured using the Fried phenotype (unintentional weight loss, exhaustion, low physical activity, weakness, and slow walking speed). Chronic conditions (obesity, diabetes, hypertension, cardiovascular and respiratory disease, and multimorbidity [≥2 conditions]) were assessed at baseline using standardized self-reported physician diagnoses. Counterfactual mediation using Cox proportional hazards models estimated the proportion of the socioeconomic disadvantage-frailty association mediated by each condition. Socioeconomic disadvantage was associated with a 1.5-2.5-fold higher risk of incident frailty. Obesity mediated 13-55% of this association, diabetes 11-22%, and multimorbidity 21-39%, whereas hypertension, cardiovascular, and respiratory disease showed minimal or no mediation. Chronic diseases-particularly obesity and diabetes-partly explain the long-term impact of socioeconomic disadvantage on frailty, underscoring stark inequities in healthy aging. Early detection and management of these conditions in socioeconomically vulnerable older adults, alongside population-level prevention and efforts to address adverse socioeconomic conditions as root causes, could help reduce these inequalities.

Companion dogs represent a valuable and emerging translational model for human aging, as they share the human environment, receive comparable medical care - yet have much shorter lifespans. Despite their potential, a validated set of canine biomarkers of aging has not yet been established. The OLD-DOG Project, launched in 2023 at the University of Padua's Veterinary Teaching Hospital, is a 30-month prospective study designed to identify and validate biomarkers of aging in companion dogs and to assess their predictive value for healthspan and lifespan, thereby evaluating the suitability of dogs as models for human aging research. A cohort of 209 privately owned dogs aged ≥ 5 years was enrolled and underwent comprehensive evaluations every six months, including clinical examinations, physical fitness testing, blood and fecal sampling, and owner questionnaires. Collected data encompass physiological, biochemical, hematological, and behavioral parameters, as well as microbiota profiles, telomere length, and DNA methylation patterns. Surplus biological material is stored to establish a long-term biobank. Preliminary cross-sectional analyses have identified consistent age-related patterns across multiple domains, including hematological and biochemical indices, inflammatory markers, and measures of physical and cognitive performance. Ongoing longitudinal analyses aim to determine the predictive value of these candidate biomarkers for morbidity and mortality, as well as to assess the influence of environmental and lifestyle factors on aging trajectories. Ultimately, the project seeks to construct an integrative model of biological age in dogs, thereby strengthening their value as a robust translational model for human aging research.

BackgroundFrailty among older adults is an escalating public health challenge, often associated with poorer quality of life (QoL) and increased pressure on healthcare systems. Integrated care is proposed as a strategy to meet the complex needs of this population, though evidence of its effectiveness remains inconclusive.ObjectivesTo determine the impact of integrated care on the quality of life of frail, community-dwelling older adults.DesignSystematic review and mixed-methods synthesis, including meta-analysis and narrative synthesis.SettingCommunity-based healthcare systems across six international studies.ParticipantsA total of 5498 frail, community-dwelling older adults across six studies: four randomised controlled trials and two quasi-experimental designs.InterventionIntegrated care interventions tailored to frailty, including person-centred, multidisciplinary, and value-based models.MeasurementsQuality of Life was the primary outcome. Secondary outcomes included social functioning and healthcare costs. Standardised tools such as SF-12, SF-36, ICECAP-O, and EQ-5D were used across studies.ResultsThe meta-analysis showed a small, non-significant improvement in QoL (SMD = 0.13, 95 % CI: -0.09 to 0.35, p = 0.24) with high heterogeneity (I² = 91 %). Tailored, multidimensional models showed greater effects, particularly in preserving social functioning. Findings on cost-effectiveness were inconsistent; some studies reported reduced hospital use, while others found increased primary care visits without cost savings.Conclusions. Integrated care may support social functioning but does not demonstrate a consistent improvement in overall QoL. Future trials should standardise QoL measurement, report intervention components clearly, include economic evaluations, and assess longer-term outcomes.

Aging is often accompanied by increasing difficulties in daily living that may compromise aging in place. In France, three main housing types can be distinguished: ordinary home (OH), intermediate housing (IH) and nursing home (NH). This study aimed to explore the relationship between functional disability, cognition, and residential transitions in older adults. Participants aged 65 years and older living in OH at baseline were drawn from three French population-based cohorts (PAQUID, Three-City and AMI), followed for up to 30 years. A hierarchical indicator of functional disability was derived from mobility, IADL and ADL disabilities, while cognitive function was assessed using the Mini Mental State Examination (MMSE). A multi-state model was applied to investigate the associations between functional disability and cognition (as time-dependent variables) with housing transitions, adjusting for sex, cohort, marital status and education. We also examined the involvement of IADL disabilities on transitions from OH to IH or NH in sex-stratified models. Sensitivity analyses were performed using lagged measures. Among 5264 included participants (mean age 74.7 ± 6.0 years; 56.9% women), 832 relocated from OH during a median follow-up of 10.2 years, including 216 to IH and 616 to NH. Mild and moderate disability, as lower MMSE scores, were independently associated with higher risks of transitioning to IH or NH, while severe disability and cognitive impairment were only associated with NH transitions. In sex-stratified analyses, transportation difficulties were associated with IH and NH transitions among women, whereas only with NH admission in men. Difficulties with handling finances in women, with medications management in men, and difficulties with shopping in both sexes were also associated with transition to NH. Intermediate housing was more frequently associated with mild or moderate disability, whereas transitions to long-term care were more often observed in participants with severe cognitive decline.

Frailty and dementia are associated with adverse health outcomes. Understanding their associated healthcare costs and quality of life can inform care of older adults. To assess Medicare costs and home time loss among Medicare fee-for-service beneficiaries across different combinations of frailty and dementia status RESEARCH DESIGN: Retrospective cohort study SUBJECTS: 5% random sample of Medicare fee-for-service beneficiaries aged 65 and older in 2019 MEASURES: Frailty and dementia were measured using validated claims-based algorithms. Annualized Medicare costs and home time loss (days) were measured in Medicare claims over one year. Among 1,148,964 Medicare beneficiaries (mean age 75.2 years, 57.7% female), 10.0% had frailty and 4.0% had dementia. Medicare costs increased with frailty severity. Dementia's association with costs varied by frailty level: higher costs among those without frailty (dementia vs. no dementia: $14,058.1 vs. $12,342.2 and lower costs among those with mild ($24,080.4 vs. $35,166.4) and moderate-severe frailty ($38,446.5 vs. $54,344.3). Both frailty and dementia were associated with greater home time loss, except among those with moderate-to-severe frailty in which home time loss was nearly identical with or without dementia (57.1 vs. 57.2 days). Medicare costs and home time loss increased with the severity of frailty while dementia's association with cost and home time loss varied by frailty level. Among those with moderate-severe frailty, individuals without dementia incurred higher costs despite similar home time. These findings underscore the importance of improved frailty recognition and care strategies addressing both conditions.